Provider Demographics
NPI:1811043532
Name:FERGUSON, ROYCE L (LPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:ROYCE
Middle Name:L
Last Name:FERGUSON
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1925 CENTURY BLVD NE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-3315
Mailing Address - Country:US
Mailing Address - Phone:404-320-6906
Mailing Address - Fax:404-320-6907
Practice Address - Street 1:1925 CENTURY BLVD NE
Practice Address - Street 2:SUITE 8
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3315
Practice Address - Country:US
Practice Address - Phone:404-320-6906
Practice Address - Fax:404-320-6907
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional